Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $274.22 / $274.22 / $274.22	Facility		$274.22	$274.22	$274.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.88 / $274.22 / $377.69	Professional		$199.88	$274.22	$377.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $543.58 / $597.94 / $989.32	Facility		$543.58	$597.94	$989.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $505.53 / $505.53 / $668.60	Professional		$505.53	$505.53	$668.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $391.05 / $1,163.26 / $1,163.26	Facility		$391.05	$1,163.26	$1,163.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $315.73 / $1,123.82 / $2,268.69	Facility		$315.73	$1,123.82	$2,268.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $230.48 / $787.50 / $1,028.76	Professional		$230.48	$787.50	$1,028.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $134.44 / $411.33 / $625.12	Facility		$134.44	$411.33	$625.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $311.26 / $534.96 / $652.29	Professional		$311.26	$534.96	$652.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $232.73 / $543.58 / $2,210.04	Facility		$232.73	$543.58	$2,210.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $206.39 / $271.19 / $591.89	Professional		$206.39	$271.19	$591.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $382.31	Professional		$50.00	$70.00	$382.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $134.44 / $411.33 / $625.12	Facility		$134.44	$411.33	$625.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $311.26 / $534.96 / $652.29	Professional		$311.26	$534.96	$652.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $543.58 / $815.37 / $1,249.60	Professional		$543.58	$815.37	$1,249.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $315.73 / $1,061.68 / $2,210.04	Facility		$315.73	$1,061.68	$2,210.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $230.48 / $315.73 / $2,567.81	Professional		$230.48	$315.73	$2,567.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $543.58 / $543.58 / $543.58	Professional		$543.58	$543.58	$543.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $434.06 / $543.58 / $543.58	Professional		$434.06	$543.58	$543.58
United Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $243.26 / $243.26	Facility		$243.26	$243.26	$243.26
United Facility/Professional Professional Modifier Low / Median / High Price $180.79 / $271.19 / $543.58	Professional		$180.79	$271.19	$543.58